Laura E. Brumariu

Parent–child attachment and internalizing symptoms in childhood and adolescence: A review of empirical findings and future directions

The purpose of this paper is to evaluate the theory and evidence for the links of parent-child attachment with internalizing problems in childhood and adolescence. We address three key questions: (a) how consistent is the evidence that attachment security or insecurity is linked to internalizing symptoms, anxiety, and depression? (b) How consistent is the evidence that specific forms of insecurity are more strongly related to internalizing symptoms, anxiety, and depression than are other forms of insecurity? (c) Are associations with internalizing symptoms, anxiety, and depression consistent for mother-child and father-child attachment? The current findings are consistent with the hypothesis that insecure attachment is associated with the development of internalizing problems. The links between specific insecure attachment patterns and internalizing problems are difficult to evaluate. Father-child and mother-child attachments have a comparable impact, although there are relatively few studies of father-child attachment. No moderators consistently affect these relations. We also propose two models of how attachment insecurity may combine with other factors to lead to anxiety or depression.

Multi-method assessment of mother-child attachment: Links to parenting and child depressive symptoms in middle childhood

This study included two different methods to assess mother–child attachment, questionnaires, and a doll play story stem interview, so their overlap could be evaluated. In addition, we investigated how attachment is related to parenting and child depression. The sample was comprised of 10- to 12-year-olds (N = 87) and their mothers. Children completed questionnaires (assessing security, avoidance, and ambivalence), and were administered a doll play interview to assess attachment patterns (security, avoidance, ambivalence, and disorganization). Two aspects of parenting (warmth/ engagement and psychological control) were assessed with child reports and observer ratings of maternal behavior. We also obtained child reports of depressive symptoms. Questionnaire and interview measures of attachment security were related to one another, and each showed predictable associations with parenting and child depression. By contrast, results were less consistent for the ambivalent and avoidant insecure attachment patterns, although disorganized attachment showed some associations with parenting and child adjustment.

Disorganized Behavior in Adolescent–Parent Interaction: Relations to Attachment State of Mind, Partner Abuse, and Psychopathology

Disoriented, punitive, and caregiving/role-confused attachment behaviors are associated with psychopathology in childhood, but have not been assessed in adolescence. A total of 120 low-income late adolescents (aged 18-23 years) and parents were assessed in a conflict-resolution paradigm. Their interactions were coded with the Goal-Corrected Partnership in Adolescence Coding Scales. Confirmatory factor analysis demonstrated that the three disorganized constructs (punitive, caregiving, and disoriented interaction) were best represented as distinct factors and were separable from a fourth factor for collaboration. The four factors were then assessed in relation to measures of attachment disorganization, partner abuse, and psychopathology. Results indicate that forms of disorganized behavior first described in early childhood can also be reliably assessed in adolescence and are associated with maladaptive outcomes across multiple domains.

Representational and questionnaire measures of attachment: A meta-analysis of relations to child internalizing and externalizing problems.

Although the quality of the attachment relationship is often cited as an important determinant of development, the extent of impact of this environmental influence in shaping behavioral outcomes has been a matter of considerable debate. This may, in part, be because of the variability in methodologies used for assessing attachment across infancy, childhood, and adolescence, including behavioral, representational, and questionnaire measures of attachment. Previous meta-analyses of the relations between attachment and internalizing and externalizing problems have focused on the behavioral measures of attachment used primarily in infancy. The current meta-analysis is a comprehensive examination of the literature on attachment and behavioral problems in children aged 3-18 years, focusing on the representational and questionnaire measures most commonly used in this age range. When secure attachment was compared with insecure attachment, modest associations with internalizing behavior (165 studies; 48,224 families; d = .58; 95% confidence interval [CI] [.52-.64]) were found. Multivariate moderator analyses were used to disentangle the unique influence of each significant univariate moderator more precisely, and results revealed that effect sizes decreased as the child aged, and were larger in studies in which the participants were ethnically White, where the child was the problem informant, and when the internalizing measure was depressive symptoms. Attachment and externalizing behavior were also associated (116 studies; 24,689 families; d = .49; 95% CI [42-.56]), and effect sizes were larger in ethnically White samples, and in those where the child was the problem informant. Avoidant, ambivalent, and disorganized attachment classifications were associated with internalizing behavior, but only disorganized attachment was associated with externalizing behavior.

Parent–Child Attachment and Emotion Regulation

Given the centrality of both parent-child attachment and emotion regulation in childrens development and adjustment, it is important to evaluate the relations between these constructs. This article discusses conceptual and empirical links between attachment and emotion regulation in middle childhood, highlights progress and challenges in the literature, and outlines future inquiries. Studies have established that securely attached children internalize effective emotion regulation strategies within the attachment relationship and are able to successfully employ adaptive emotion regulation strategies outside the attachment relationship, when the attachment figure is not present. There are not enough studies to conclude yet that the insecure attachment patterns (ambivalent, avoidant, and disorganized) may relate differentially with emotion regulation processes. Studies investigating whether there are unique links between the four attachment patterns and the various emotion regulation processes will advance the field considerably. Studies evaluating the associations between attachment and emotion regulation will benefit from a multimethod approach in measuring these constructs. Embedding the relation between parent-child attachment and emotion regulation within broader developmental models will further advance the research on this topic.

Mother-child relationships, family context, and child characteristics as predictors of anxiety symptoms in middle childhood.

The goal of the study was to examine several factors that may explain the development of anxiety symptoms in middle childhood. Using data from the NICHD Study of Early Child Care (n = 1,364 families), we examined mother-child relationships, other aspects of family context, and child characteristics as predictors of anxiety in preadolescence. Latent growth curve analyses revealed that children who were more anxious at the beginning of middle childhood had been more behaviorally inhibited as preschoolers, and in middle childhood lived in families who experienced more negative life events and had mothers who were more anxious. Children who became more anxious across middle childhood were less behaviorally inhibited as preschoolers and in middle childhood perceived less security in their attachments to their mothers, experienced more negative life events, and had mothers who were more anxious. The findings illustrate the need to include a broad set of risk factors in etiological models of anxiety. In addition, the evidence for cumulative effects suggests several possible points of intervention with anxious children and their parents.

Quality of Attachment Relationships and Peer Relationship Dysfunction Among Late Adolescents With and Without Anxiety Disorders

Little is known about the links between anxiety disorders and parent-child attachment disorganization and quality of peer relationships in late adolescence. This study examined the quality of attachment and peer relationships among adolescents with and without anxiety disorders in a sample of 109 low- to moderate-income families. Psychopathology was assessed with the SCID-I. Attachment disorganization and dysfunction in peer relationships were measured using semi-structured interviews and behavioral observations. Adolescents with anxiety disorders and comorbid conditions showed higher levels of attachment disorganization across three measurement approaches, as well as higher levels of dysfunction in peer relationships than those with no Axis I diagnosis. Adolescents without anxiety disorders but with other Axis I disorders differed only in the quality of school relationships from those with no diagnoses. The pattern of results suggests that pathological anxiety, in the context of other comorbidities, may be a marker for more pervasive levels of social impairment.

Reactivity, regulation, and reward responses to infant cues among mothers with and without psychopathology: an fMRI review

Despite important progress in understanding the complex caregiving system, developmental research has only recently begun to focus on the mothers internal affective state and its role in sensitive caregiving behavior. This review will summarize recent findings of functional neuroimaging research to elaborate on the neural components associated with maternal sensitive care or disrupted responsiveness to infant communications. First, maternal emotion reactivity and regulation, as well as maternal reward responsiveness to infant cues, will be reviewed among healthy mothers. Then, emotion and reward-related processes among mothers who display sensitive versus disrupted caregiving will be explored. Finally, these patterns of response will be compared to patterns of response among mothers with psychiatric disorders, including depression, posttraumatic stress disorder, and substance abuse. The aim of this review is to examine whether differences in emotion reactivity and regulation, as well as in the encoding of infant stimuli as rewarding, are related either to maternal psychopathology or to maternal difficulties in responding promptly and appropriately to their infants. A summary of the challenges facing developmental neuroscience research in furthering our understanding of maternal responses to infants will close this review.

ROLE CONFUSION AND DISORIENTATION IN YOUNG ADULT-PARENT INTERACTION AMONG INDIVIDUALS WITH BORDERLINE SYMPTOMATOLOGY

Borderline symptoms are thought to emerge from the interaction of temperamental factors and environmental stressors. Both parental invalidation and attachment disorganization have been hypothesized to play an etiological role. However, to date the quality of parent-child interaction has not been observed directly. In this study, 120 young adults were assessed for features of borderline personality disorder on the SCID II, for severity of childhood maltreatment on interview and self-report measures, and for disturbance in parent-child interaction during a videotaped conflict discussion task. Borderline traits, as well as suicidality/self-injury specifically, were associated with more role confusion and more disoriented behavior in interaction with the parent. Among young adults with recurrent suicidality/self-injury, 40% displayed high levels of role confusion compared to 16% of those who were not suicidal. Neither form of disturbed interaction mediated the independent effect of childhood abuse on borderline symptoms. A parent-child transactional model is proposed to account for the findings.

Homesickness at Summer Camp: Associations with the Mother-Child Relationship, Social Self-Concept, and Peer Relationships in Middle Childhood

The goal of the present study was to investigate how the quality of the mother-child relationship, social self-concept, and the quality of peer relationships predict girls’ feelings of homesickness at a residential summer camp. We expected that children with secure attachments to their mothers, a more positive social self-concept, and better relationships with peers would report less homesickness at camp. Girls were 8 to 12 years of age. Mother-child attachment was assessed with a questionnaire and an interview completed prior to camp. Social self-concept was assessed with a questionnaire prior to camp, and peer relationships were assessed with questionnaires at camp. Peer relationships and social self-concept, but not mother-child attachment, were related to homesickness at camp. Social self-concept prior to camp and peer social support and friendship quality at camp predicted subsequent homesickness, whereas homesickness early in camp did not predict later assessments of peer relationships at camp. The findings suggest that social self-concept and relationships with peers may be protective factors for homesickness at summer camp.